Reconstruction of the Posterolateral Corner of the Knee With Achilles Tendon Allograft Scott A. Kuzma, M.D., Roxanne M. Chow, M.D., William M. Engasser,

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Reconstruction of the Posterolateral Corner of the Knee With Achilles Tendon Allograft Scott A. Kuzma, M.D., Roxanne M. Chow, M.D., William M. Engasser, B.A., Michael J. Stuart, M.D., Bruce A. Levy, M.D. Arthroscopy Techniques Volume 3, Issue 3, Pages e393-e398 (June 2014) DOI: 10.1016/j.eats.2014.02.006 Copyright © 2014 Arthroscopy Association of North America Terms and Conditions

Fig 1 (A) Pictorial representation of our single–Achilles tendon allograft PLC reconstruction technique depicting the femoral and transfibular tunnel placement and final construct, including fixation with interference screws in the femoral tunnels and (B) posterolateral capsular shift and imbrication to the graft construct. (Reprinted with permission.12) Arthroscopy Techniques 2014 3, e393-e398DOI: (10.1016/j.eats.2014.02.006) Copyright © 2014 Arthroscopy Association of North America Terms and Conditions

Fig 2 Curvilinear skin incision for PLC reconstruction of left knee. The patient is supine. Shown in the photograph are the fibular head (rightward-pointing arrow), joint line (downward-pointing arrow), and lateral epicondyle (upward-pointing arrow). Arthroscopy Techniques 2014 3, e393-e398DOI: (10.1016/j.eats.2014.02.006) Copyright © 2014 Arthroscopy Association of North America Terms and Conditions

Fig 3 Soft-tissue dissection exposing peroneal nerve (downward-pointing arrow) with retraction of biceps femoris tendon (upward-pointing arrow). The retractor is 1 cm proximal to the fibular head. Arthroscopy Techniques 2014 3, e393-e398DOI: (10.1016/j.eats.2014.02.006) Copyright © 2014 Arthroscopy Association of North America Terms and Conditions

Fig 4 Soft-tissue dissection exposing popliteus tendon (leftward-pointing arrow), lateral femoral condyle including popliteal sulcus (rightward-pointing arrow), and tunnel created in fibular head (downward-pointing arrow). Arthroscopy Techniques 2014 3, e393-e398DOI: (10.1016/j.eats.2014.02.006) Copyright © 2014 Arthroscopy Association of North America Terms and Conditions

Fig 5 Anteroposterior fluoroscopic view of socket placement for popliteus portion of PLC graft. Arthroscopy Techniques 2014 3, e393-e398DOI: (10.1016/j.eats.2014.02.006) Copyright © 2014 Arthroscopy Association of North America Terms and Conditions

Fig 6 Lateral fluoroscopic view of fibular tunnel placement from anterolateral fibular head to posteromedial insertion of PFL at fibular styloid. Arthroscopy Techniques 2014 3, e393-e398DOI: (10.1016/j.eats.2014.02.006) Copyright © 2014 Arthroscopy Association of North America Terms and Conditions

Fig 7 Anteroposterior fluoroscopic view of pin placement for FCL tunnel from anatomic insertion of FCL to superomedial femur running parallel to popliteal socket. Arthroscopy Techniques 2014 3, e393-e398DOI: (10.1016/j.eats.2014.02.006) Copyright © 2014 Arthroscopy Association of North America Terms and Conditions

Fig 8 (A) Anteroposterior and (B) lateral fluoroscopic views of final graft reconstruction fixation showing popliteus graft with BioComposite screw (arrow with no tail), FCL limb with TightRope button on lateral femur (arrowhead), fibular graft fixation with BioComposite screw (arrow with tail), and 3 capsular suture anchors (triangle). Arthroscopy Techniques 2014 3, e393-e398DOI: (10.1016/j.eats.2014.02.006) Copyright © 2014 Arthroscopy Association of North America Terms and Conditions

Fig 9 Intraoperative photograph of final PLC construct with popliteus portion of graft (downward-pointing arrow) and fibular collateral portion of graft (upward-pointing arrows). Arthroscopy Techniques 2014 3, e393-e398DOI: (10.1016/j.eats.2014.02.006) Copyright © 2014 Arthroscopy Association of North America Terms and Conditions

Fig 10 Postoperative anteroposterior radiograph of knee placed in hinged rehabilitation brace with slight valgus mold. Arthroscopy Techniques 2014 3, e393-e398DOI: (10.1016/j.eats.2014.02.006) Copyright © 2014 Arthroscopy Association of North America Terms and Conditions